Journal of Ophthalmic and Vision Research

ISSN: 2008-322X

The latest research in clinical ophthalmology and the science of vision.

Rituximab Monotherapy versus Rituximab and Bortezomib Combination Therapy for Treatment of Non-paraneoplastic Autoimmune Retinopathy

Published date: Nov 24 2022

Journal Title: Journal of Ophthalmic and Vision Research

Issue title: Oct–Dec 2022, Volume 17, Issue 4

Pages: 515–528

DOI: 10.18502/jovr.v17i4.12304

Authors:

Arash MalekiMassachusetts Eye Research and Surgery Institution, Waltham, MA, USA

Amanda ColomboMassachusetts Eye Research and Surgery Institution, Waltham, MA, USA

Sydney Look-WhyMassachusetts Eye Research and Surgery Institution, Waltham, MA, USA

Peter ChangMassachusetts Eye Research and Surgery Institution, Waltham, MA, USA

Stephen AnesiMassachusetts Eye Research and Surgery Institution, Waltham, MA, USA

C. Stephen Fostersfoster@mersi.comMassachusetts Eye Research and Surgery Institution, Waltham, MA, USA

Abstract:

Purpose: To study whether rituximab and bortezomib combination therapy is more effective than rituximab monotherapy in the treatment of nonparaneoplastic autoimmune retinopathy (npAIR).

Methods: Retrospective case series involving six patients with npAIR, taking either rituximab and bortezomib combination therapy (three cases) or rituximab monotherapy (one case and two historical patients).

Results: Patients on both treatment regimens showed stability in most of the visual function parameters during the one year of follow-up. Combination therapy resulted in improvement of scotopic combined rod and cone a-wave and b-wave amplitudes in all eyes where they were available (four eyes); however, rituximab monotherapy resulted in only two eyes with stable scotopic combined rod and cone a-wave and b-wave amplitudes, while four eyes showed a decrease in both a- and b-wave amplitudes. The average improvement in b-wave amplitude (50.7% ± 29.4% [range 25–90%]) was higher than the average improvement in awave amplitude (35.7% ± 9.74 [range 25–63%]). No severe adverse effects were reported.

Conclusion: Rituximab and bortezomib combination therapy may not be more effective than rituximab monotherapy in npAIR patients for most of the visual function parameters; however, this combination therapy may be more effective in improving scotopic combined rod and cone a- and b-wave amplitudes. This may indicate the higher efficacy of combination therapy when there is involvement of the inner retina.

Keywords: Autoimmune Retinopathy, Bortezomib, Electroretinography, Nonparaneoplastic AIR, Rituximab, Visual Field

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